US20140336635A1 - Surgical forceps - Google Patents

Surgical forceps Download PDF

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US20140336635A1
US20140336635A1 US14/176,341 US201414176341A US2014336635A1 US 20140336635 A1 US20140336635 A1 US 20140336635A1 US 201414176341 A US201414176341 A US 201414176341A US 2014336635 A1 US2014336635 A1 US 2014336635A1
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Prior art keywords
shaft
position
members
member
jaw
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US14/176,341
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US9622810B2 (en
Inventor
Keir Hart
Mark J. Huseman
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Covidien LP
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Covidien LP
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Priority to US14/176,341 priority patent/US9622810B2/en
Assigned to COVIDIEN LP reassignment COVIDIEN LP ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: Hart, Keir, HUSEMAN, MARK J.
Publication of US20140336635A1 publication Critical patent/US20140336635A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082Probes or electrodes therefor
    • A61B18/085Forceps, scissors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2804Surgical forceps with two or more pivotal connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2812Surgical forceps with a single pivotal connection
    • A61B17/2833Locking means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2812Surgical forceps with a single pivotal connection
    • A61B17/2841Handles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • A61B34/76Manipulators having means for providing feel, e.g. force or tactile feedback
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0042Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
    • A61B2017/00424Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping ergonomic, e.g. fitting in fist
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091Handpieces of the surgical instrument or device
    • A61B2018/00916Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/00922Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device by switching or controlling the treatment energy directly within the hand-piece
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure

Abstract

A surgical forceps includes a first shaft member including a proximal portion having a handle at a proximal end thereof and a distal portion having a jaw member at a distal end thereof. The proximal and distal portions are pivotable between an aligned position and an angled position. A second shaft member includes a jaw member at a distal end thereof and a handle at a proximal end thereof. The shaft members are pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween. The proximal portion of the first shaft member is pivoted relative to the distal portion of the first shaft member from the aligned position to the angled position upon movement of the first and second shaft members towards the spaced-apart position.

Description

    CROSS REFERENCE TO RELATED APPLICATION
  • The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 61/822,047, filed on May 10, 2013, the entire contents of which are incorporated herein by reference.
  • BACKGROUND
  • 1. Technical Field
  • The present disclosure relates to surgical devices and, more particularly, to hemostat-style surgical forceps for grasping, treating, and cutting tissue.
  • 2. Background of Related Art
  • A surgical forceps is a plier-like device which relies on mechanical action between its jaws to grasp, clamp, and constrict tissue. Energy-based surgical forceps utilize both mechanical clamping action and energy to affect hemostasis by heating tissue to coagulate and/or cauterize tissue. Certain surgical procedures require more than simply cauterizing tissue and rely on the unique combination of clamping pressure, precise energy control and gap distance (i.e., distance between opposing jaw members when closed about tissue) to “seal” tissue. Typically, once tissue is sealed, the surgeon has to accurately sever the tissue along the newly formed tissue seal. Accordingly, many tissue sealing devices have been designed which incorporate a knife or blade member which effectively severs the tissue after forming a tissue seal. More recently, tissue sealing devices have incorporated energy-based cutting features for energy-based tissue division.
  • With respect to hemostat-style surgical forceps for use in relatively deep openings and/or in confined spaces, longer shaft members provide the surgeon with the ability to reach the target tissue. However, as the lengths of the shaft members increase, so does the range of motion required to open and close the jaw members.
  • SUMMARY
  • As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user. Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.
  • In accordance with aspects of the present disclosure, a surgical forceps is provided. the surgical forceps includes a first shaft member and a second shaft member. The first shaft member includes a proximal portion having a handle disposed at a proximal end thereof, and a distal portion having a jaw member disposed at a distal end thereof. The proximal and distal portions are pivotably coupled to one another and are pivotable relative to one another between an aligned position, wherein the proximal and distal portions cooperate to define a substantially linear configuration, and an angled position, wherein the proximal portion is angled relative to the distal portion. The second shaft member includes a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof. The first and second shaft members are pivotably coupled to one another towards the distal end of the distal portion of the first shaft member and the distal end of the second shaft member and are pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween. The proximal portion of the first shaft member is pivoted relative to the distal portion of the first shaft member from the aligned position to the angled position upon movement of the first and second shaft members towards the spaced-apart position.
  • In an aspect of the present disclosure, in the angled position, the proximal portion of the first shaft member is angled towards the second shaft member to decrease a distance between the handles of the first and second shaft members.
  • In another aspect of the present disclosure, a stop member is disposed on one of the proximal and distal portions of the first shaft member. The stop member is configured to inhibit pivoting of the proximal portion away from the second shaft member beyond the aligned position.
  • In yet another aspect of the present disclosure, each of the handles defines a finger hole therethrough.
  • In still another aspects of the present disclosure, a locking mechanism is disposed on the first shaft member. The locking mechanism is configured to selectively lock the proximal and distal portions of the first shaft member in the aligned position.
  • In still yet another aspect of the present disclosure, one or both of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue. In such aspects, one of the shaft members may further include an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
  • In accordance with aspects of the present disclosure, another surgical forceps is provided that include a first jaw member having a distal jaw body and a proximal jaw flange extending proximally from the distal jaw body. The proximal jaw flange includes an extension portion having a transverse pin extending therethrough. A first shaft member is also provided. The first shaft member has a handle disposed at a proximal end thereof and includes a distal end defining an opening and one or more slots adjacent the opening. The extension portion of the proximal jaw flange extends into the opening and the transverse pin is disposed within the slot(s). The transverse pin is movable from a first end of the slot(s), wherein the first shaft member and the extension portion cooperate to define a substantially linear configuration, to a second end of the slot(s), wherein the first shaft member is angled relative to the extension portion. A second shaft member including a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof is also provided. The jaw member of the second shaft member is pivotably coupled to the jaw member of the first shaft member. The first and second shaft members are pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween. The first shaft member is moved from the first end of the slot(s) towards the second end of the slot(s) upon movement of the first and second shaft members towards the spaced-apart position.
  • In an aspect of the present disclosure, in the angled position, the handle of the first shaft member is angled towards the second shaft member to decrease a distance between the handles of the first and second shaft members.
  • In another aspect of the present disclosure, each of the handles defines a finger hole therethrough.
  • In yet another aspect of the present disclosure, a linkage is coupled between the first and second shaft members. In such aspects, the linkage may be pivotably coupled to one of the shaft members and coupled to the other shaft member via a slot-pin engagement. Further still, the linkage may be configured such that, in the approximated position of the shaft members, the linkage is disposed in an angled position, and such that, in the spaced-apart position of the shaft members, the linkage is disposed in a substantially vertical position.
  • In still another aspect of the present disclosure, one or both of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue. In such aspects, one of the shaft members may further include an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
  • In accordance with aspects of the present disclosure, another surgical forceps is provided that includes first and second shaft members, each including a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof. The first and second shaft members are pivotably coupled to one another towards the distal ends thereof and are pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween. The handles of the first and second shaft members extend inwardly towards one another and are longitudinally offset relative to one another.
  • In an aspect of the present disclosure, each shaft member defines an outer dimension along an outwardly-facing side thereof. The handles of the respective shaft members are fully disposed within the respective outer dimensions.
  • In another aspect of the present disclosure, one of the shaft members defines a recess configured to at least partially receive the handle of the other shaft member upon movement of the shaft members to the approximated position.
  • In yet another aspect of the present disclosure, one or both of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue. In such aspects, one of the shaft members may further include an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • Various aspects and features of the present disclosure are described herein with reference to the drawings wherein:
  • FIG. 1A is a perspective view of a forceps provided in accordance with the present disclosure, configured for grasping, treating, and electrically cutting tissue;
  • FIG. 1B is a perspective view of another forceps provided in accordance with the present disclosure, configured for grasping, treating, and mechanically cutting tissue;
  • FIG. 2A is a transverse, cross-sectional view of the end effector assembly of the forceps of FIG. 1A;
  • FIG. 2B is a transverse, cross-sectional view of the end effector assembly of the forceps of FIG. 1B;
  • FIG. 3A is a side view of another forceps provided in accordance with the present disclosure, wherein jaw members of the end effector assembly of the forceps are disposed in a closed position;
  • FIG. 3B is a side view of the forceps of FIG. 3A, wherein the jaw members are disposed in an open position;
  • FIG. 3C is an enlarged view of the area of detail indicated as “3C” in FIG. 3A;
  • FIG. 4A is a side view of another forceps provided in accordance with the present disclosure, wherein jaw members of the end effector assembly of the forceps are disposed in a closed position;
  • FIG. 4B is a enlarged view of the area of detail indicated as “4B” in FIG. 4A;
  • FIG. 4C is a side view of the forceps of FIG. 4A, wherein the jaw member are disposed in an open position;
  • FIG. 4D is a enlarged view of the area of detail indicated as “4D” in FIG. 4C; and
  • FIG. 5 is a side view of another forceps provided in accordance with the present disclosure.
  • DETAILED DESCRIPTION
  • Turning to FIGS. 1A and 1B, two embodiments of hemostat-style surgical forceps configured for use in accordance with the present disclosure in a variety of surgical procedures are shown generally identified by reference numerals 10 and 10′, respectively, although it is contemplated that any other suitable surgical device may be utilized in accordance with the present disclosure. Obviously, different electrical and mechanical connections and considerations apply to each particular type of device, however, the aspects and features of the present disclosure remain generally consistent regardless of the particular device used.
  • Referring to FIG. 1A, forceps 10 is shown including two elongated shaft members 12 a and 12 b each having a distal end 14 a and 14 b and a proximal end 16 a and 16 b, respectively. End effector assembly 100, including opposing jaw members 110, 120, is attached to distal ends 14 a and 14 b of shaft members 12 a and 12 b, respectively. A pivot pin 103 is interdisposed between shaft members 12 a, 12 b and the respective jaw members 110, 120 thereof such that shaft members 12 a, 12 b may be pivoted relative to one another between a spaced-apart position and an approximated position to effect movement of jaw members 110, 120 relative to one another between an open position and a closed position, respectively, for grasping tissue therebetween.
  • Each shaft member 12 a, 12 b includes a handle 17 a, 17 b disposed at the proximal end 16 a, 16 b thereof. Each handle 17 a, 17 b defines a finger hole 18 a, 18 b therethrough for receiving a finger of the user. As can be appreciated, finger holes 18 a, 18 b facilitate movement of shaft members 12 a, 12 b relative to one another to, in turn, pivot jaw members 110, 120 from the open position to the closed position for grasping tissue therebetween.
  • One of shaft members 12 a, 12 b, e.g., shaft member 12 a, includes a proximal shaft connector 19 configured to connect forceps 10 to a source of energy, e.g., a generator (not shown). Proximal shaft connector 19 secures a cable 8 to forceps 10 such that the user may selectively supply energy, e.g., electrosurgical energy, to jaw members 110, 120 for treating, e.g., sealing, tissue and for energy-based tissue cutting. More specifically, a first activation assembly 80 is provided for supplying energy to jaw members 110, 120 to treat tissue upon sufficient approximation of shaft members 12 a, 12 b, e.g., upon activation of activation button 82 via shaft member 12 b. A second activation assembly 84 including a selectively depressible activation button 86 is provided one of the shaft members 12 a, 12 b, e.g., shaft member 12 b, for selectively supplying energy, e.g., electrosurgical energy, to either or both of jaw members 110, 120 for energy-based tissue cutting.
  • With additional reference to FIG. 2A, end effector assembly 100 of forceps 10 includes first and second jaw members 110, 120, each including a proximal flange portion 111 a, 121 a, a distal jaw portion 111 b, 121 b, an outer insulative jaw housing 112, 122, and a tissue-contacting plate 114, 124, respectively. Proximal flange portions 111 a, 121 a of jaw members 110, 120 are pivotably coupled to one another about pivot pin 103 for moving jaw members 110, 120 between the open and closed positions upon movement of shaft members 12 a, 12 b between the spaced-apart and approximated positions. Proximal flange portions 111 a, 121 a may be fixedly engaged, integrally formed, releasably engaged, or otherwise or secured to respective shaft members 12 a, 12 b. Distal jaw portions 111 b, 121 b of jaw members 110, 120 are configured to support jaw housings 112, 122, and tissue-contacting plates 114, 124, respectively, thereon. Further, one of the jaw members 110, 120, e.g., jaw members 120, includes an energy-based cutting member 130 disposed thereon, as will be described in greater detail below.
  • Tissue-contacting plates 114, 124 are formed from an electrically conductive material, e.g., for conducting electrical energy therebetween for treating tissue, although tissue-contacting plates 114, 124 may alternatively be configured to conduct any suitable energy through tissue grasped therebetween for energy-based tissue treatment, e.g., tissue sealing. Energy-based cutting member 130 is likewise formed from an electrically conductive material, e.g., for conducting electrical energy between energy-based cutting member 130 and one or both of tissue-contacting plates 114, 124 for electrically cutting tissue, although energy-based cutting member 130 may alternatively be configured to conduct any suitable energy through tissue for electrically cutting tissue.
  • Tissue-contacting plates 114, 124 are coupled to activation switch 82 and the source of energy (not shown) such that energy, e.g., electrosurgical energy, may be selectively supplied to tissue-contacting plate 114 and/or tissue-contacting plate 124 and conducted therebetween and through tissue disposed between jaw members 110, 120 to treat, e.g., seal, tissue in a first mode of operation. Likewise, cutting member 130 is similarly coupled to activation switch 86 and the source of energy (not shown) such that energy, e.g., electrosurgical energy, may be selectively supplied to cutting member 130 and conducted through tissue disposed between jaw members 110, 120 to either or both of tissue-contacting plates 114, 124 to cut tissue in a second mode of operation. A first insulating member 150 surrounds cutting member 130 to insulate tissue-contacting plate 124 and cutting member 130 from one another. A second insulating member 160 disposed within a longitudinal slot defined within tissue-contacting plate 114 of jaw member 110 opposes cutting member 130 to insulate cutting member 130 from tissue-contacting plate 114 of jaw member 110 when jaw members 110, 120 are disposed in the approximated position.
  • Turning to FIG. 1B, forceps 10′ is similar to forceps 10 (FIG. 1A) and, thus, only the differences therebetween will be described in detail below for purposes of brevity. Forceps 10′ generally includes two elongated shaft members 12 a′ and 12 b′ and an end effector assembly 200 including opposing jaw members 210, 220 attached at distal ends 14 a′ and 14 b′ of shaft members 12 a′, 12 b′. One of the shaft members 12 a′, 12 b′, e.g., shaft member 12 b′, further includes a trigger assembly 84′ including a selectively actuatable trigger 86′ operably coupled to a cutting member 230 (FIG. 2B) for selectively advancing cutting member 230 (FIG. 2B) between jaw members 210, 220 to cut tissue grasped therebetween. That is, forceps 10′ differs from forceps 10 (FIG. 1A) in that forceps 10′ is configured for mechanical tissue cutting, while forceps 10 (FIG. 1A) is configured for electrical tissue cutting.
  • With additional reference to FIG. 2B, end effector assembly 200 of forceps 10′ is similar to end effector assembly 100 of forceps 10 (see FIGS. 1A and 2A) and may include any of the features of end effector assembly 100 (FIG. 2A), except where specifically contradicted below. End effector assembly 200 includes first and second jaw members 210, 220, each including a tissue-contacting plate 214, 224 and a longitudinally-extending slot 216, 226, respectively. A cutting member 230 is configured for longitudinal translation through slots 216, 226 of jaw members 210, 220, e.g., upon activation of trigger 86′, to mechanically cut tissue grasped between jaw members 210, 220.
  • Turning now to FIGS. 3A-5, various embodiments of shaft members and/or shaft assemblies configured for use with forceps similar to forceps 10, 10′ (FIGS. 1A and 1B, respectively), are described in detail below. The various embodiments detailed below may include any of the features of forceps 10, 10′ (FIGS. 1A and 1B, respectively). Further, to the extent consistent, any of the embodiments detailed below may include any or all of the features of any of the other embodiments detailed below. For the purposes of brevity, similar features described above with respect to forceps 10, 10′ (FIGS. 1A and 1B, respectively) or any of the other embodiments detailed herein will only be summarily described or omitted entirely.
  • The various embodiments of forceps described hereinbelow are particularly useful for surgical procedures requiring the surgeon to grasp, treat, and/or cut tissue positioned within deep openings and/or in confined spaces, although these forceps are similarly advantageous for grasping, treating, and/or cutting tissue in a variety of other surgical procedures. More specifically, the presently disclosed embodiments of forceps include shaft members having increased lengths and/or extended shaft assemblies, while also including components and/or features that account for the increased range of motion requirements for opening and closing jaw members associated with such increased length shafts and/or extended shaft assemblies.
  • Referring to FIGS. 3A-3C, another embodiment of a forceps provided in accordance with the present disclosure is shown generally identified by reference numeral 300. Forceps 300 is shown generally including a pair of elongated shaft members 312 a and 312 b an end effector assembly 3100 having first and second jaw members 3110, 3120, disposed at the distal ends of shaft members 312 a, 312 b. Similarly as described above, a pivot pin 3103 pivotably couples shaft members 312 a, 312 b and, thus, the jaw members 3110, 3120 thereof such that shaft members 312 a, 312 b may be pivoted relative to one another between a spaced-apart position and an approximated position to effect movement of jaw members 3110, 3120 relative to one another between an open position and a closed position, respectively, for grasping tissue therebetween.
  • One or both of the shaft members 312 a, 312 b, e.g., shaft member 312 a, includes a distal portion 314 a and a proximal portion 316 a that are interconnected via a pivot assembly 320. Distal portion 314 a includes jaw member 3110 disposed at the distal end thereof and is pivotably coupled to shaft member 312 b via pivot pin 3103. Proximal portion 316 a includes a handle 317 a, which defines a finger hole 318 a, disposed towards the proximal end thereof and further includes an activation assembly 380 disposed towards the proximal end thereof.
  • Pivot assembly 320 includes a pivot member 322 that pivotably couples the adjacent ends of distal and proximal portions 314 a, 316 a, respectively, to one another such that proximal portion 316 a may pivot about pivot member 322 and relative to distal portion 314 a between an aligned position, wherein shaft member 312 a defines a substantially linear configuration with distal and proximal portions 314 a, 316 a substantially aligned with one another (FIG. 3A), and an angled position, wherein shaft member 312 a defines an angled configuration with proximal portion 316 a angled towards shaft member 312 b and relative to distal portion 314 a (FIG. 3B).
  • With particular reference to FIG. 3C, in conjunction with FIGS. 3A-3B, pivot assembly 320, in some embodiments, further includes a stop member 324 disposed on the adjacent end of either of distal and proximal portions 314 a, 316 a, e.g., proximal portion 316 a, for inhibiting proximal portion 316 a from pivoting about pivot member 322 relative to distal portion 314 a and away from shaft member 312 b beyond the aligned position. Pivot member 322 may also define an internal passage 326 extending therethrough to permit passage of wires 308 between distal and proximal portions 314 a, 316 a, for coupling the source of energy (not shown) and activation assembly 380 to end effector assembly 3100 (see FIGS. 3A-3B).
  • In some embodiments, one of the distal and proximal portions 314 a, 316 a, e.g., distal portion 314 a, of shaft member 312 a includes a locking mechanism 340 for releasably locking proximal portion 316 a in the aligned position. Locking mechanism 340 includes a housing 342 extending from distal portion 314 a adjacent pivot assembly 320. Housing 342 slidably receives a locking bar 344. An actuator 346 extends through a slot 343 defined within housing 342 and is coupled to locking bar 344 such that translation of actuator 346 through slot 343 effects movement of locking bar 344 between a retracted position, wherein locking bar 344 is positioned distally of pivot assembly 320, and an extended position, wherein locking bar 344 extends proximally beyond pivot assembly 320 to at least partially overlap proximal portion 316 a. As can be appreciated, in the extended position, locking bar 344 and stop member 324 cooperate to substantially inhibit pivoting of proximal portion 316 a, thereby retaining proximal portion 316 a in the aligned position. Other suitable locking mechanisms 340 are also contemplated.
  • Forceps 300 is configured to enable full opening of jaw members 3110, 3120 while reducing the range of motion, e.g., the distance between handles 317 a, 317 b of shaft members 312 a, 312 b, respectively, required to fully open jaw members 3110, 3120. As detailed above, such a feature is advantageous for use with elongated shaft members, although this feature is also advantageous in other situation, e.g., for surgeons having smaller hands.
  • Referring still to FIGS. 3A-3C, in use, in order to move jaw members 3110, 3120 to the fully open position, the surgeon, with a finger inserted through each of finger holes 318 a, 318 b of handles 317 a, 317 b, respectively, moves shaft members 312 a, 312 b apart from one another from the approximated position (FIG. 3A) towards the spaced-apart position (FIG. 3B) to pivot jaw members 3110, 3120 from the closed position (FIG. 3A) towards the open position (FIG. 3B). As shaft members 312 a, 312 b are moved further towards the spaced-apart position, e.g., as handles 317 a, 317 b are moved further apart from one another, the surgeon's ability to further space-apart shaft members 312 a, 312 b is constrained by the size of the surgeon's hand and/or the surgeon's ability to spread handles 317 a, 317 b. However, pivot assembly 320, with locking bar 344 of locking mechanism 340 in the retracted position, allows proximal portion 316 a of shaft member 312 a to pivot relative to distal portion 314 a of shaft member 312 a and towards shaft member 312 b from the aligned position (FIG. 3A) to the angled position (FIG. 3B) as shaft members 312 a, 312 b are moved further towards the spaced-apart position, thereby reducing the distance between handles 317 a, 317 b and facilitating full opening of jaw members 3110, 3120 (FIG. 3B). Where use of pivot assembly 320 is not desired, locking bar 344 of locking mechanism 340 may be moved from the retracted position to the extended position to lock shaft member 312 a in the aligned position (FIG. 3A) throughout movement of shaft members 312 a, 312 b between the spaced-apart and approximated positions.
  • In order to move jaw members 3110, 3120 to the closed position for grasping tissue therebetween, the surgeon moves shaft members 312 a, 312 b towards one another. As shaft members 312 a, 312 b are moved further towards the approximated position, proximal portion 316 a of shaft member 312 a is pivoted relative to distal portion 314 a of shaft member 312 and away from shaft member 312 b from the angled position (FIG. 3B) to the aligned position (FIG. 3A) such that shaft members 312 a, 312 b may be fully approximated and, thus, such that jaw members 3110, 3120 may be fully closed about tissue grasped therebetween. Fully closing jaw members 3110, 3120 about tissue is important in that it has been found that a grasping pressure in the range of about 3 kg/cm2 to about 16 kg/cm2 and a gap distance of about 0.001 inches to about 0.006 inches between jaw members 3110, 3120 facilitates formation of an effective tissue seal, although other ranges are also contemplated.
  • Referring to FIGS. 4A-4D, another forceps provided in accordance with the present disclosure is shown generally identified by reference numeral 400. Forceps 400 is shown generally including a pair of elongated shaft members 412 a, 412 b, and an end effector assembly 4100 having first and second jaw members 4110, 4120, disposed at the distal ends of shaft members 412 a, 412 b. Similarly as described above, a pivot pin 4103 pivotably couples shaft members 412 a, 412 b and, thus, the jaw members 4110, 4120 thereof such that shaft members 412 a, 412 b may be pivoted relative to one another between a spaced-apart position and an approximated position to effect movement of jaw members 4110, 4120 relative to one another between an open position and a closed position, respectively, for grasping tissue therebetween.
  • One or both of the shaft members 412 a, 412 b, e.g., shaft member 412 a, is movably coupled to its respective jaw member 4110. The other shaft member 412 b may likewise be movably coupled to its respective jaw member 4120, or may be fixedly engaged, integrally formed, or otherwise secured thereto. More specifically, proximal flange portion 4111 a of jaw member 4110 includes a proximal extension 4112 including a transverse pin 4113 extending from either side thereof. Shaft member 412 a defines a opening (not explicitly shown) towards the distal end thereof that is configured to receive proximal extension 4112 of proximal flange portion 4111 a of jaw member 4110, and further defines an angled slot 414 on each opposed side wall thereof (only one of which is shown) for receiving the portions of transverse pin 4113 extending from each side of proximal extension 4112. The reverse configuration is also contemplated, e.g., wherein flange portion 4111 a of jaw member 4110 defines a pair of slots and wherein shaft member 412 a includes a transverse pin extending from both sides thereof and through the slots.
  • Continuing with reference to FIGS. 4A-4D, forceps 400 further includes a linkage 440 interconnecting shaft members 412 a, 412 b proximally of pivot pin 4103. Linkage 440 is pivotably coupled to shaft member 412 b via a pivot pin 442 and is coupled to shaft member 412 a via a slot-pin engagement 444, although this configuration may be reversed. As shaft members 412 a, 412 b are moved between the spaced-apart and approximated positions to open and close jaw members 4110, 4120, first end 443 of linkage 440 is pivoted about pivot pin 442 relative to shaft member 412 b and second end 445 of linkage 440 is both pivoted relative to shaft member 412 a and translated along the slot of slot-pin engagement 444 to permit such movement of shaft members 412 a, 412 b relative to one another. Linkage 440 provides stability and support to shaft members 412 a, 412 b. However, in some embodiments, linkage 440 is not provided.
  • Similarly as described above with respect to forceps 300 (FIGS. 3A-3C), forceps 400 is configured to enable full opening of jaw members 4110, 4120 while reducing the range of motion, e.g., the distance between handles 417 a, 417 b of shaft members 412 a, 412 b, respectively, required to fully open jaw members 4110, 4120.
  • With shaft members 412 a, 412 b disposed in the approximated position and, accordingly, jaw members 4110, 4120 disposed in the closed position, as shown in FIGS. 4A and 4B, transverse pin 4113 is disposed at first ends 415 of angled slots 414 of shaft member 412 a such that shaft member 412 a is disposed in substantial alignment with proximal flange portion 4111 a of jaw member 4110. Further, in the approximated position of shaft members 412 a, 412 b, linkage 440 is disposed in an angled position.
  • In order to move jaw members 4110, 4120 from the closed position (FIG. 4A) to the fully open position (FIG. 4B), the surgeon, with a finger engaged with each handle 417 a, 417 b, moves shaft members 412 a, 412 b apart from one another from the approximated position (FIG. 4A) towards the spaced-apart position (FIG. 4B) to pivot jaw members 4110, 4120 from the closed position (FIG. 4A) towards the open position (FIG. 4B). As shaft members 412 a, 412 b are moved further towards the spaced-apart position, transverse pin 4113 is moved along slots 414 from the first ends 415 thereof (FIG. 4C) towards the second ends 416 thereof (FIG. 4D) such that shaft member 412 a is moved relative to proximal flange portion 4111 a of jaw member 4110 from the aligned position (FIG. 4C) to an angled position (FIG. 4D), wherein shaft member 412 a is offset relative to proximal flange portion 4111 a of jaw member 4110 and extends towards shaft member 412 b, thereby reducing the distance between handles 417 a, 417 b and facilitating full opening of jaw members 4110, 4120 (FIG. 4B). In the spaced-apart position of shaft members 412 a, 412 b, corresponding to the open position of jaw members 4110, 4120, linkage 440 is disposed in a substantially vertical position, as shown in FIG. 4C.
  • In order to move jaw members 4110, 4120 to the closed position for grasping tissue therebetween, the surgeon moves shaft members 412 a, 412 b towards one another such that, eventually, transverse pin 4113 is moved along slots 414 from the second ends 416 back to the first ends 415 thereof to return shaft member 412 a back to the aligned position, jaw members 4110, 4120 are fully closed, e.g., to grasp tissue therebetween, and linkage 440 is moved back to the angled position.
  • Turning to FIG. 5, another embodiment of a forceps provided in accordance with the present disclosure is shown generally identified by reference numeral 500. Forceps 500 is shown including two elongated shaft members 512 a and 512 b and an end effector assembly 5100 including opposing jaw members 5110, 5120 attached to distal ends 514 a and 514 b of shaft members 512 a and 512 b, respectively. Shaft members 512 a, 512 b are pivotable relative to one another between a spaced-apart position and an approximated position to effect movement of jaw members 5110, 5120 relative to one another between an open position and a closed position, respectively, for grasping tissue therebetween.
  • Each shaft member 512 a, 512 b of forceps 500 includes a handle 517 a, 517 b disposed at the proximal end 516 a, 516 b thereof. Each handle 517 a, 517 b defines a finger hole 518 a, 518 b therethrough for receiving a finger of the user. Handles 517 a, 517 b generally define increased dimensions as compared to the remainder of shaft members 512 a, 512 b, respectively, such that finger holes 518 a, 518 b are sufficiently large to permit insertion of a surgeon's finger therethrough. Handles 517 a, 517 b are configured such that this increased dimension extends inwardly towards the other shaft member 512 b, 512 a, respectively. That is, the portions of shaft members 512 b, 512 a adjacent handles 517 a, 517 b on the outwardly-facing sides thereof do not extend outwardly beyond the outer-most dimensions of shaft members 512 a, 512 b. As a result of this configuration, finger holes 518 a, 518 b are positioned closer to one another than can be achieved where at least a portion of either or both of handles 517 a, 517 b extend outwardly from its respective shaft member 512 a, 512 b. Similarly as described above, such a feature is advantageous in that it increases the surgeon's ability to move jaw members 5110, 5120 to the fully open position.
  • However, although the above configuration of handles 517 a, 517 b facilitates the surgeon's ability to fully open jaw members 5110, 5120, such an inwardly-extending handle 517 a, 517 b alone would inhibit the ability to fully close jaw members 5110, 5120, e.g., to achieve an appropriate grasping pressure and/or gap distance. As such, handles 517 a, 517 b of forceps 500 are longitudinally-offset relative to one another. That is, handle 517 a is offset proximally relative to handle 517 b, thus allowing shaft members 512 a, 512 b to be fully approximated and, accordingly, allowing jaw members 5110, 5120 to be fully closed. It is also envisioned that this configuration be reversed, e.g., wherein handle 517 a is offset distally relative to handle 517 b. Further, one or both of shaft members 512 a, 512 b, e.g., shaft member 512 a, may further include a recess 519 a shaped complementary or partially-complementary to and configured to receive handle 517 b to permit further approximation of shaft members 512 a, 512 b.
  • The various embodiments disclosed hereinabove may additionally or alternatively be configured to work with robotic surgical systems and what is commonly referred to as “Telesurgery.” Such systems employ various robotic elements to assist the surgeon in the operating theatre and allow remote operation (or partial remote operation) of surgical instrumentation. Various robotic arms, gears, cams, pulleys, electric and mechanical motors, etc. may be employed for this purpose and may be designed with a robotic surgical system to assist the surgeon during the course of an operation or treatment. Such robotic systems may include, remotely steerable systems, automatically flexible surgical systems, remotely flexible surgical systems, remotely articulating surgical systems, wireless surgical systems, modular or selectively configurable remotely operated surgical systems, etc.
  • The robotic surgical systems may be employed with one or more consoles that are next to the operating theater or located in a remote location. In this instance, one team of surgeons or nurses may prep the patient for surgery and configure the robotic surgical system with one or more of the instruments disclosed herein while another surgeon (or group of surgeons) remotely controls the instruments via the robotic surgical system. As can be appreciated, a highly skilled surgeon may perform multiple operations in multiple locations without leaving his/her remote console which can be both economically advantageous and a benefit to the patient or a series of patients.
  • The robotic arms of the surgical system are typically coupled to a pair of master handles by a controller. The handles can be moved by the surgeon to produce a corresponding movement of the working ends of any type of surgical instrument (e.g., end effectors, graspers, knifes, scissors, etc.) which may complement the use of one or more of the embodiments described herein. The movement of the master handles may be scaled so that the working ends have a corresponding movement that is different, smaller or larger, than the movement performed by the operating hands of the surgeon. The scale factor or gearing ratio may be adjustable so that the operator can control the resolution of the working ends of the surgical instrument(s).
  • The master handles may include various sensors to provide feedback to the surgeon relating to various tissue parameters or conditions, e.g., tissue resistance due to manipulation, cutting or otherwise treating, pressure by the instrument onto the tissue, tissue temperature, tissue impedance, etc. As can be appreciated, such sensors provide the surgeon with enhanced tactile feedback simulating actual operating conditions. The master handles may also include a variety of different actuators for delicate tissue manipulation or treatment further enhancing the surgeon's ability to mimic actual operating conditions.
  • From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.

Claims (20)

What is claimed is:
1. A surgical forceps, comprising:
a first shaft member including a proximal portion including a handle disposed at a proximal end thereof and a distal portion including a jaw member disposed at a distal end thereof, the proximal and distal portions pivotably coupled to one another and pivotable relative to one another between an aligned position, wherein the proximal and distal portions cooperate to define a substantially linear configuration, and an angled position, wherein the proximal portion is angled relative to the distal portion; and
a second shaft member including a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof, the first and second shaft members pivotably coupled to one another towards the distal end of the distal portion of the first shaft member and the distal end of the second shaft member and pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween,
wherein the proximal portion of the first shaft member is pivoted relative to the distal portion of the first shaft member from the aligned position to the angled position upon movement of the first and second shaft members towards the spaced-apart position.
2. The surgical forceps according to claim 1, wherein, in the angled position, the proximal portion of the first shaft member is angled towards the second shaft member to decrease a distance between the handles of the first and second shaft members.
3. The surgical forceps according to claim 2, further comprising a stop member disposed on one of the proximal and distal portions of the first shaft member, the stop member configured to inhibit pivoting of the proximal portion away from the second shaft member beyond the aligned position.
4. The surgical forceps according to claim 1, wherein each of the handles defines a finger hole therethrough.
5. The surgical forceps according to claim 1, further comprising a locking mechanism disposed on the first shaft member, the locking mechanism configured to selectively lock the proximal and distal portions of the first shaft member in the aligned position.
6. The surgical forceps according to claim 1, wherein at least one of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue.
7. The surgical forceps according to claim 6, wherein one of the shaft members include an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
8. A surgical forceps, comprising:
a first jaw member including a distal jaw body and a proximal jaw flange extending proximally from the distal jaw body, the proximal jaw flange including an extension portion having a transverse pin extending therethrough;
a first shaft member having a handle disposed at a proximal end thereof and including a distal end defining an opening and at least one slot adjacent the opening, the extension portion of the proximal jaw flange extending into the opening and the transverse pin disposed within the at least one slot, the transverse pin movable from a first end of the at least one slot, wherein the first shaft member and the extension portion cooperate to define a substantially linear configuration, to a second end of the at least one slot, wherein the first shaft member is angled relative to the extension portion; and
a second shaft member including a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof, the jaw member of the second shaft member pivotably coupled to the jaw member of the first shaft member, the first and second shaft members pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween,
wherein the first shaft member is moved from the first end of the at least one slot towards the second end of the at least one slot upon movement of the first and second shaft members towards the spaced-apart position.
9. The surgical forceps according to claim 8, wherein, in the angled position, the handle of the first shaft member is angled towards the second shaft member to decrease a distance between the handles of the first and second shaft members.
10. The surgical forceps according to claim 8, wherein each of the handles defines a finger hole therethrough.
11. The surgical forceps according to claim 8, further comprising a linkage coupled between the first and second shaft members.
12. The surgical forceps according to claim 11, wherein the linkage is pivotably coupled to one of the shaft members and is coupled to the other shaft member via a slot-pin engagement.
13. The surgical forceps according to claim 11, wherein, in the approximated position of the shaft members, the linkage is disposed in an angled position, and wherein, in the spaced-apart position of the shaft members, the linkage is disposed in a substantially vertical position.
14. The surgical forceps according to claim 8, wherein at least one of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue.
15. The surgical forceps according to claim 14, wherein one of the shaft members includes an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
16. A surgical forceps, comprising:
first and second shaft members, each shaft member including a jaw member disposed at a distal end thereof and a handle disposed at a proximal end thereof, the first and second shaft members pivotably coupled to one another towards the distal ends thereof and pivotable relative to one another between a spaced-apart position and an approximated position for moving the jaw members relative to one another between an open position and a closed position to grasp tissue therebetween, the handles of the first and second shaft members extending inwardly towards one another and longitudinally offset relative to one another.
17. The surgical forceps according to claim 16, wherein each shaft member defines an outer dimension along an outwardly-facing side thereof and wherein the handles of the respective shaft members are fully disposed within the respective outer dimensions.
18. The surgical forceps according to claim 16, wherein one of the shaft members defines a recess configured to at least partially receive the handle of the other shaft member upon movement of the shaft members to the approximated position.
19. The surgical forceps according to claim 16, wherein least one of the jaw members is adapted to connect to a source of energy for conducting energy through tissue grasped between the jaw members to treat tissue.
20. The surgical forceps according to claim 19, wherein one of the shaft members includes an activation button positioned to oppose the other shaft member such that energy is supplied to the at least one jaw member upon movement of the shaft members to the approximated position.
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